Objective. The article discusses the advantages of performing stress tests with pressure control at each heartbeat. The question of increasing accuracy, informativeness and safety of the test is considered.
   Materials and methods. We performed 30 bicycle ergometric tests with ECG measurement, beat to beat blood pressure measurement and periodic blood pressure measurement by the Korotkoff method in the shoulder.
   Results. It was shown that arterial pressure registered by Korotkoff sounds in the shoulder corresponded with continuous pressure at the registration moment. Because of the impossibility to measure the dynamics, the underestimation of maximum systolic arterial pressure by the Korotkoff method exceeds 20 mm Hg in every 3 tests, and exceeds 30 mm Hg in every 5 tests. Therefore, the beat to beat measurement of BP significantly improves the accuracy and informativeness value of stress tests.
   Conclusions. Continuous BP signal in the finger increases reliability of noisy Korotkoff sounds extraction and the results of BP measurement in the shoulder by the classical method. The increased accuracy and reliability of the measurement provides greater patient safety. Continuous pressure corrected by Korotkoff sounds during reference measurements in the shoulder gives a detailed and accurate picture of BP variations, which allows to investigate in detail features of the patient’s cardiovascular system regulation, both during and after the load, which is not available with classical BP measurement.

   This article is the description of three clinical cases of the application of a new echocardiographic technique — the estimation of the left ventricular (LV) myocardial work parameters by constructing pressure - strain loops in patients with arterial hypertension, hypertrophic and dilated cardiomyopathies. The specific variations of global and regional LV myocardial work indices distribution, typical for each pathology, are clearly demonstrated, the results of current scientific studies on each disease are also briefly presented.

   Objective. To evaluate the alterations of Global longitudinsl strain (GLS) and it’s value for prediction of cardiotoxicity of low to moderate cumulative doses of anthracyclines.
   Methods. Forty-nine women 50 ± 10 years old with breast cancer, treated with anthracyclines (cumulative dose of 251 ± 60 mg/m2) were enrolled in the study. Echocardiography with GLS measurement was performed at baseline, at the end of anthracycline treatment, then every 3 months during 1 year. Cardiotoxicity was defined as a decline in left ventricular ejection fraction (LVEF) of at least 10 % to ≤ 53 %.
   Results. There was a significant increase in mean LVESV and LVEDV and decrease of GLS (р < 0,05) but not LVEF at 3 month post anthracycline treatment. Cardiotoxicity was detected in 8 patients (16 %) with moderate baseline risk. Absolute ≥ 4 % reduction of GLS during follow-up, GLS and
percent of it’s reduction from baseline to 3 month post-anthracycline were predictive of cardiotoxicity (AUC = 0,822 and 0,870, respectively). The reduction in GLS of >12,5 % from baseline at 3 month post anthracyclines was predictive of cardiotoxicity with sensitivity of 80 % and specificity of 95 %.
   Conclusions. GLS and its reduction from baseline has shown predictive value for development of cardiotoxicity in patients with moderate risk treated with low-to moderate cumulative doses of antracyclines. Additional echocardiography with GLS assessment at 3–6 month after completion of anthracycline treatment may be recommended irrespective of cardiotoxicity risk.

   Myasthenia gravis is an autoimmune disease, the clinical manifestations of which are in the form of weakness and pathological muscle fatigue. We present the clinical case of a patient with predominantly lingual muscle involvement. The patient was diagnosed with a generalized 2A–2B form of myasthenia gravis. Dysarthria and weakness of the masticatory muscles were observed at the onset of the disease. The diagnosis was established 1.5 months after the appearance of the first complaints. Diagnosis at the outpatient stage was hampered by the epidemiological history and the short duration of symptoms that occurred only after eating. All of the above determines the importance of clinician`s alertness about the possibility of this disease manifesting itself in such a rather specific and rare group of symptoms.

   The article proposes a method for calculating the required amount of equipment that allows an organization to correctly purchase a sufficient number of Holter ECG monitoring devices for functional diagnostics departments in order to meet the standards of medical care for patients with cardiac pathology in an outpatient setting. The method takes into account the volume of diagnostic studies performed and compares their number with the requirements of the standards. Holter ECG monitors are considered to be essential material expenditures of medical institutions to maintain proper medical and diagnostic process at the proper level. The functional features of the medical information system at the regional level in the Russian Federation are highlighted. Emphasis is placed on Holter monitoring of the electrocardiogram as one of methods for examining patients with cardiac pathology in relation to the standards of medical care for specific diseases.The essence and significance of the standards of medical care for the healthcare system in general and for the cardiological service, in particular, have been revealed. The article is intended for healthcare organizers and heads of structural divisions, services and departments of functional diagnostics.

   Objectives: This study set out to determine the possibility to differ SARS-СоV-2 viral pneumonia from community acquired pneumonia (CAP) by mean of digital infrared medical thermography.
   Material, methods: Totally 380 patients were evaluated: with diagnosis 'U07.1COVID-19, virus identified. SARS-CoV-2 pneumonia' (group 1) — 208 pts, with community acquired viral or bacterial pneumonia (group 2) — 172 pts. Thermographic assessment was performed using TBC300-med infrared camera (manufactured by LLC 'STC SILAR', Saint Petersburg, Russia, image format 384 x 288, thermal resolution 30 mK). To store and analyze thermographic images cloud application 'TVision' (LLC 'Dignosys', Russia) was used. Quadrangle in shape regions of interest (ROI) were automatically created on the front and back of the thorax roughly in the projection of the upper lobe (ULP) and the lower lobe (LLP) of the lungs. Mean temperature was measured and thermal gradients- ΔТ° (side-to-side temperature difference) - were calculated between symmetric ROI both on front and back of the thorax. Values obtained were taken as modulus, the greatest value used for analysis.
   Results: Mean ΔТ° value were significantly higher in SARS-CoV-2 pneumonia compared with CAP group (0,56 ± 0,35 ºC and 0,32 ± 0,14ºC respectively; P < 0,05). The ΔТ° value > 0,51 °C is associated with SARS-CoV-2 pneumonia with sensitivity 71 % and specificity 62,8 %, area under the ROC curve 0.739; P < 0,05).
   Conclusions. Infrared thermography proved to be a sensitive method for detection of temperature differences between both types of pneumonia and may contribute to preliminary diagnosis.

   Since 1921, at the monthly scientific meetings of the Kazan Clinical Institute, opened in 1920, later renamed the Kazan Institute for the Improvement of Physicians, GIDUV, the head of the Department of Physiology of the Faculty of Physics and Mathematics of Kazan University, a world-famous physiologist, made presentations and debates more than once, one of the creators of the theory of electrocardiography and neuromuscular transmission, Professor A. F. Samoilov. A scientist with an encyclopedic education, he generously shared his knowledge with an audience of doctors, took an active part in the development of the scientific life of the Kazan Clinical Institute. His reports at scientific meetings familiarized physicians with the results of the experimental work of the physiological laboratory of A. F. Samoilov at Kazan University, with the works and scientific position of famous physiologists. Scientific meetings, speeches and the presence of prominent scientists of Kazan, rich in form and content of discussions of reports, scientific discussions have become a school of creative thinking for the young generation of doctors and scientists of the Kazan Clinical Institute — GIDUV. The article for the first time presents materials about these speeches by A. F. Samoilov about G. Helmholtz, J. Loeb, recordings of heart sounds, about the galvanic skin reflex, about setting up a scientific and educational process at universities in the USA and Europe.

   The article is devoted to the centenary of the birth of the outstanding Soviet and Russian scientist, Honored Scientist of the Russian Federation, Honorary Cardiologist of Russia, Professor Max Solomonovich Kushakovsky. M. S. Kushakovsky made an invaluable contribution to the development of functional diagnostics in our country, especially to the development of electrocardiography and electrophysiology of the heart, as well as to the development of echocardiography as a method that allows assessing not only not only structural features of the heart, but also features of intracardiac and central hemodynamics. The works of M. S. Kushakovsky contributed to the solution of many problems related to the diagnosis and treatment of cardiac arrhythmias, arterial hypertension, cardiomyopathies and other diseases of the heart. M. S. Kushakovsky’s monographs serve as a source of knowledge for many generations of Russian doctors. A monument on his grave at the Bolsheokhtensky Cemetery in St. Petersburg and a bas-relief on the building of the Pokrovskaya Hospital in St. Petersburg, built on donations of the city’s doctors, are dedicated to the memory of Professor M. S. Kushakovsky. The name of M. S. Kushakovsky was assigned to the Department of Cardiology, which he led during his lifetime.